Methods and compositions for diagnosis and treatment of iron overload diseases and iron deficiency diseases

ABSTRACT

Methods and compositions are provided for the diagnosis and treatment of iron overload diseases and iron deficiency diseases.

The present application is a divisional application of co-pending U.S.application Ser. No. 09/094,964, filed Jun. 12, 1998, incorporatedherein by reference in its entirety, which is a continuation-in-part ofU.S. application Ser. No. 08/876,010, filed Jun. 13, 1997, nowabandoned, which is incorporated herein by reference in its entirety.

BACKGROUND OF THE INVENTION

Hereditary hemochromatosis (HH) is a common disease characterized byexcess iron deposition in the major organs of the body (Dadone, M. M. etal. AM. J. Clin. Pathol. 78:196–207 (1982); Edwards, C. Q. et al. N.Enql. J. Med. 18:1355–1362. (1988); McLaren, C. E., et al. Blood86:2021–2027 (1995); Bothwell, T. H. et al., The metabolic and molecularbasis of inherited disease (ed. C. R. Scriver, E. A.) 2237–2269(McGraw-Hill, New York, 1995); Bacon, B. R. et al., Hepatoloqy. Atextbook of liver disease (eds. Zakim, D. & Boyer, T. D.) 1439–1472 (W.B. Saunders, Philadelphia, 1996). A candidate gene for this disease,HFE, was identified by positional cloning (Feder, J. N., et al. NatureGenetics 13:399–408 (1996)). The gene, a novel member of the MHC class Ifamily, was found to have a mutation, cysteine 282-->tyrosine (C282Y),in 83% of patient chromosomes (Feder, J. N., et al. Nature Genetics13:399–408 (1996)). This mutation eliminates the ability of HFE toassociate with β₂-microglobulin (β₂m) and prevents cell-surfaceexpression (Feder, J. N., et al., J. Biol. Chem. 272:14025–14028(1997)). However, the relationship of this class I-like molecule to theregulation of iron metabolism has remained obscure.

Thus, an object of the instant invention is to provide a molecular basisfor the relationship of HFE to iron metabolism, and diagnostic andtherapeutic agents for the treatment of iron overload diseases and irondeficiency diseases.

SUMMARY OF THE INVENTION

One aspect of the invention is a method of treating an iron overloaddisease by administering to a patient an HFE polypeptide having thesequence of SEQ ID NO:1,

RLLRSHSLHYLFMGASEQDLGLSLFEALGYVDDQLFVFYDHESRRVEPRTPWVSSRISSQMWLQLSQSLKGWDHMFTVDFWTIMENHNHSKESHTLQVILGCEMQEDNSTEGYWKYGYDGQDHLEFCPDTLDWRAAEPRAWPTKLEWERHKIRARQNRAYLERDCPAQLQQLLELGRGVLDQQVPPLVKVTHHVTSSVTTLRCRALNYYPQNITMKWLKDKQPMDAKEFEPKDVLPNGDGTYQGWITLAVPPGEEQRYTCQVEHPGLDQPLIVIWE,wherein the HFE polypeptide is provided in a complex with full length,wild type human β₂m.

A further aspect of the invention is a composition of an HFE polypeptidehaving the amino acid sequence of SEQ ID NO:1,

RLLRSHSLHYLFMGASEQDLGLSLFEALGYVDDQLFVFYDHESRRVEPRTPWVSSRISSQMWLQLSQSLKGWDHMFTVDFWTIMENHNHSKESHTLQVILGCEMQEDNSTEGYWKYGYDGQDHLEFCPDTLDWRAAEPRAWPTKLEWERHKIRARQNRAYLERDCPAQLQQLLELGRGVLDQQVPPLVKVTHHVTSSVTTLRCRALNYYPQNITMKWLKDKQPMDAKEFEPKDVLPNGDGTYQGWITLAVPPGEEQRYTCQVEHPGLDQPLIVIWE,wherein the HFE polypeptide is provided in a complex with full length,wild type human β₂m.

A further aspect of the invention is a method of treating an irondeficiency disease by administering to a patient an HFE polypeptide,i.e., H63D-HFE mutant, having the sequence of SEQ ID NO:2,

RLLRSHSLHYLFMGASEQDLGLSLFEALGYVDDQLFVFYDDESRRVEPRTPWVSSRISSQMWLQLSQSLKGWDHMFTVDFWTIMENHNHSKESHTLQVILGCEMQEDNSTEGYWKYGYDGQDHLEFCPDTLDWRAAEPRAWPTKLEWERHKIRARQNRAYLERDCPAQLQQLLELGRGVLDQQVPPLVKVTHHVTSSVTTLRCRALNYYPQNITMKWLKDKQPMDAKEFEPKDVLPNGDGTYQGWITALVPPGEEQRYTCQVEHPGLDQPLIVIWE,wherein the HFE polypeptide is provided in a complex with full length,wild type human β₂m.

A further aspect of the invention is a composition of an HFEpolypeptide, i.e., H63D-HFE mutant, having the amino acid sequence ofSEQ ID NO:2,

RLLRSHSLHYLFMGASEQDLGLSLFEALGYVDDQLFVFYDDESRRVEPRTPWVSSRISSQMWLQLSQSLKGWDHMFTVDFWTIMENHNHSKESHTLQVILGCEMQEDNSTEGYWKYGYDGQDHLEFCPDTLDWRAAEPRAWPTKLEWERHKIRARQNRAYLERDCPAQLQQLLELGRGVLDQQVPPLVKVTHHVTSSVTTLRCRALNYYPQNITMKWLKDKQPMDAKEFEPKDVLPNGDGTYQGWITLAVPPGEEQRYTCQVEHPGLDQPLIVIWE,wherein the HFE polypeptide is provided in a complex with full length,wild type human β₂m.

A further aspect of the invention is a method of treating an irondeficiency disease by administering to a patient an HFE polypeptide,i.e., H111A/H145A-HFE mutant, having the sequence of SEQ ID NO:3,

RLLRSHSLHYLFMGASEQDLGLSLFEALGYVDDQLFVFYDHESRRVEPRTPWVSSRISSQMWLQLSQSLKGWDHMFTVDFWTIMENHNASKESHTLQVILGCEMQEDNSTEGYWKYGYDGQDALEFCPDTLDWRAAEPRAWPTKLEWERHKIRARQNRAYLERDCPAQLQQLLELGRGVLDQQVPPLVKVTHHVTSSVTTLRCRALNYYPQNITMKWLKDKQPMDAKEFEPKDVLPNGDGTYQGWITLAVPPGEEQRYTCQVEHPGLDQPLIVIWE,wherein the HFE polypeptide is provided in a complex with full length,wild type human β₂m.

A further aspect of the invention is a composition of an HFEpolypeptide, i.e., H111A/H145A-HFE mutant, having the amino acidsequence of SEQ ID NO:3,

RLLRSHSLHYLFMGASEQDLGLSLFEALGYVDDQLFVFYDHESRRVEPRTPWVSSRISSQMWLQLSQSLKGWDHMFTVDFWTIMENHNASKESHTLQVILGCEMQEDNSTEGYWKYGYDGQDALEFCPDTLCWRAAEPRAWPTKLEWERHKIRARQNRAYLERDCPAQLQQLLELGRGVLDQQVPPLVKVTHHVTSSVTTLRCRALNYYPQNITMKWLKDKQPMDAKEFEPKDVLPNGDGTYQGWITLAVPPGEEQRYTCQVEHPGLDQPLIVIWE,wherein the HFE polypeptide is provided in a complex with full length,wild type human β₂m.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1A–1D. Cell-surface labeling of HFE and association with TfR. (FIG.1A) HFE antibodies immunoprecipitate 12, 49, 100, and 200 kDasurface-labeled proteins from wild-type HFE expressing cells but notfrom parental 293 or C282Y HFE mutant expressing cells. (FIG. 1B) FLAGepitope antibodies also immunoprecipitate 12, 49, 100, and 200 kDasurface-labeled proteins in wild-type HFE expressing cells but notparental 293 or C282Y HFE mutant expressing cells. (FIG. 1C) TfRantibodies immunoprecipitate 100 and 200 kDa surface-labeled proteinsfrom parental 293, wild-type and C282Y HFE expressing cells and inaddition, detect β₂m (12 kDa) and HFE (49 kDa) proteins only inwild-type HFE expressing cells. (FIG. 1D) HLA-ABC antibodies fail toimmunoprecipitate 100 and 200 kDa proteins from parental 293 cells.

FIG. 2A–2E. Direct association of TfR with HFE. (FIG. 2A) HFE antibodiesco-immunoprecipitate TfR from wild-type and H63D HFE expressing cellsbut not 293 or C282Y HFE mutant expressing cells. (FIG. 2B) HFEantibodies immunoprecipitate similar amounts of HFE protein fromwild-type, C282Y and H63D HFE expressing cells. (FIG. 2C) TfR antibodiesco-immunoprecipitate HFE from wild-type and H63D HFE expresser cells butnot parental 293 or C282Y mutant expressing cells. (FIG. 2D) TfRantibodies immunoprecipitate similar amounts of TfR protein fromparental 293, and wild-type, C282Y and H63D HFE expressing cells. (FIG.2E) FLAG epitope (M2) antibodies co-immunoprecipitate TfR from wild-typeand H63D HFE expressing cells but not parental 293 or C282Y HFE mutantexpressing cells.

FIG. 3A–3C. Effect of HFE on ¹²⁵I-transferrin binding to the TfR. (FIG.3A) Transferrin binding to TfR in cells that over-express the C282Ymutant protein (intracellular) (inset). Cells (clone 10 open squares andclone 12, closed squares) were incubated with various concentrations oftransferrin at 37° C. for 20 mins. The data represent the mean ofduplicate determinations corrected for non-specific binding. Scatchardanalysis revealed an apparent K_(D) of approximately 14 and 12 nMrespectively, with the number of apparent transferrin binding sites of2×10⁵ and 3×10⁵ per cell. (FIG. 3B) Binding of ¹²⁵I-transferrin to twoclones of 293 cells overexpressing the wild type (surface) form of HFE(clone 7, open circles; clone 3, closed circles). Saturation of thetransferrin receptors occurred at approximately the same concentrationas in (FIG. 3A), however, the amount of-transferrin bound was reduced2–4 fold (inset). Scatchard analysis revealed that the affinity fortransferrin had been reduced to 180 and 40 nM, and number of apparenttransferrin binding sites of 9.0×10⁴ to 2.5×10⁵ per cell. (FIG. 3C)Binding of ¹²⁵I-transferrin to 293 cells in the presence of solubleHFE/β₂m heterodimers. 293 cells bind transferrin at 37° C., with anapparent K_(D) of 19 nM (open squares), whereas in the presence of 2 μMof soluble HFE/β₂m heterodimers, the K_(D) is reduced 5 fold to 100 nM(open triangles). Control experiments using an identical amount of anMHC class I, H-2K^(d) 15 protein complexed with human β₂m failed to haveany affect of transferrin binding (closed circles).

SPECIFIC EMBODIMENTS OF THE INVENTION

In some embodiments of the invention, HFE polypeptides are provided fortherapeutic use in patients having symptoms of a primary iron overloaddisease or syndrome, such as hemochromatosis, or other iron overloadcondition caused by secondary causes, such as repeated transfusions. TheHFE polypeptide can be full length HFE or some fragment of HFE.Preferably, the HFE polypeptide comprises the extracellular portion ofthe HFE. The predicted amino acid sequence and genomic and cDNAsequences of HFE (also denoted HH in some publications) were provided in(Feder, J. N., et al. Nature Genetics 13:399–408 (1996); Ruddy et al.,Genome Res. 7:441–456 (1997)), hereby incorporated by reference in itsentirety. The HFE polypeptides may be administered withβ2-microglobulin, such as in the form of a complex. In some embodiments,HFE polypeptides greater than about 20 amino acids are administered in acomplex with β-2-microglobulin.

In some embodiments of the invention, agonists or antagonists of the HFEprotein or transferrin receptor are provided. Agonists of the HFEpolypeptide, and/or antagonists of the transferrin receptor, are usefulfor example, in the treatment of primary or secondary iron overloaddiseases or syndromes, while antagonists of the HFE polypeptide, oragonists of the transferrin receptor are useful, for example, in thetreatment of iron deficiency conditions, such as anemias. In otherembodiments, mutant HFE proteins are provided which function asantagonists of the wild-type HFE protein. In a specific embodimentillustrated by working examples HFE antagonists include a solubletruncated HFE polypeptide in which a His residue is substituted by anAsp residue at position 63, and a soluble truncated HFE polypeptide inwhich His residues at positions 111 and 145 are substituted by an Alaresidue. Antagonists or agonists can also be antibodies, preferablymonoclonal antibodies, directed against the transferrin receptor orextracellular region of the HFE polypeptide. In some embodiments of theinvention, HFE polypeptides can serve as antagonists of the transferrinreceptor. In further embodiments of the invention, peptidomimetics canbe designed using techniques well known in the art as antagonists oragonists of the HFE protein and/or the transferrin receptor.

Ligands for the transferrin receptor, whether antagonists or agonists,can be screened using the techniques described herein for the ability tobind to the transferrin receptor. Additionally, competition for HFEbinding to the receptor can be done using techniques well known in theart. Ligands, or more generally, binding partners for the HFEpolypeptide can be screened, for example, for the ability to inhibit thecomplexing of the HFE polypeptide to β-2-microglobulin, using techniquesdescribed herein.

In some embodiments of the invention, agonists or antagonists oftransferrin are similarly utilized to increase or decrease the amount ofiron transported into a cell, such as into a patient's hepatocytes orlymphocytes.

For example, the efficacy of a drug, therapeutic agent, agonist, orantagonist can be identified in a screening program in which modulationis monitored in in vitro cell systems. Host cell systems which expressvarious mutant HFE proteins (especially the 24d1 and 24d2 mutations) andare suited for use as primary screening systems. Candidate drugs can beevaluated by incubation with these cells and measuring cellularfunctions dependent on the HFE gene or by measuring proper HFE proteinfolding or processing. Such assays might also entail measuringreceptor-like activity, iron transport and metabolism, genetranscription or other upstream or downstream biological function asdictated by studies of HFE gene function.

Alternatively, cell-free systems can also be utilized. Purified HFEprotein can be reconstituted into artificial membranes or vesicles anddrugs screened in a cell-free system. Such systems are often moreconvenient and are inherently more amenable to high throughput types ofscreening and automation.

In some embodiments of the invention, the HFE protein can be purified byone of several methods which have been selected based upon the molecularproperties revealed by its sequence and its homology to MHC Class Imolecules. Since the molecule possesses properties of an integralmembrane protein, i.e. contains a transmembrane domain, the protein ispreferably first isolated from the membrane fraction of cells usingdetergent solubilization. A variety of detergents useful for thispurpose are well known in the art.

Once solubilized, the HFE protein can be further purified byconventional affinity chromatography techniques. The conventionalapproaches of ion exchange, hydrophobic interaction, and/ororganomercurial chromatographies can be utilized. These methodologiestake advantage of natural features of the primary structure, such as:charged amino acid residues, hydrophobic transmembrane domains, andsulfhydryl-containing cysteine residues, respectively. In the affinitychromatography approach use is made of immunoaffinity ligands or of theproposed interaction of the HFE protein with β-2-microglobulin, calnexinor similar molecules. In the former, the affinity matrix consists ofantibodies (polyclonal or monoclonal) specific to the HFE proteincoupled to an inert matrix. The production of antibodies specific to theHFE protein can be performed using techniques well known in the art. Inthe latter method, various ligands which are proposed to specificallyinteract with the HFE protein based on its homology with MHC Class Imolecules could be immobilized on an inert matrix. For example,β-2-microglobulin, β-2-microglobulin-like molecules, or other specificproteins such as calnexin or calnexin-like molecules, and the like, orportions and/or fragments thereof, can be utilized. General methods forpreparation and use of affinity matrices are well known in the art.

Criteria for the determination of the purity of the HFE protein includethose standard to the field of protein chemistry. These includeN-terminal amino acid determination, one and two-dimensionalpolyacrylamide gel electrophoresis, and silver staining. The purifiedprotein is useful for use in studies related to the determination ofsecondary and tertiary structure, as aid in drug design, and for invitro study of the biological function of the molecule.

In some embodiments of the invention, drugs can be designed to modulateHFE gene and HFE protein activity from knowledge of the structure andfunction correlations of HFE protein and from knowledge of the specificdefect in various HFE mutant proteins. For this, rational drug design byuse of X-ray crystallography, computer-aided molecular modeling (CAMM),quantitative or qualitative structure-activity relationship (QSAR), andsimilar technologies can further focus drug discovery efforts. Rationaldesign allows prediction of protein or synthetic structures which caninteract with and modify the HFE protein activity. Such structures maybe synthesized chemically or expressed in biological systems. Thisapproach has been reviewed in Capsey et al., Genetically EngineeredHuman Therapeutic Drugs, Stockton Press, New York (1988). Further,combinatorial libraries can-be designed, synthesized and used inscreening programs.

In order to administer therapeutic agents based on, or derived from, thepresent invention, it will be appreciated that suitable carriers,excipients, and other agents may be incorporated into the formulationsto provide improved transfer, delivery, tolerance, and the like.

A multitude of appropriate formulations can be found in the formularyknown to all pharmaceutical chemists: Remington's PharmaceuticalSciences, (15th Edition, Mack Publishing Company, Easton, Pa. (1975)),particularly Chapter 87, by Blaug, Seymour, therein. These formulationsinclude for example, powders, pastes, ointments, jelly, waxes, oils,lipids, anhydrous absorption bases, oil-in-water or water-in-oilemulsions, emulsions carbowax (polyethylene glycols of a variety ofmolecular weights), semi-solid gels, and semi-solid mixtures containingcarbowax.

Any of the foregoing formulations may be appropriate in treatments andtherapies in accordance with the present invention, provided that theactive agent in the formulation is not inactivated by the formulationand the formulation is physiologically compatible.

The present invention also relates to the use of polypeptide or proteinreplacement therapy for those individuals determined to have a defectiveHFE gene. Treatment of HH disease can be performed by replacing thedefective HFE protein with normal protein or its functional equivalentin therapeutic amounts. A therapeutic amount of an HFE polypeptide for“replacement therapy”, an HFE agonist, or transferrin receptorantagonist is an amount sufficient to decrease the amount of irontransported into a cell. Preferably, the cell is a lymphocyte.

Similarly, a therapeutic amount of an HFE antagonist or transferrinreceptor agonist is an amount sufficient to increase the amount of irontransported into a cell.

HFE-polypeptide can be prepared for therapy by any of severalconventional procedures. First, HFE protein can be produced by cloningthe HFE cDNA into an appropriate expression vector, expressing the HFEgene product from this vector in an in vitro expression system(cell-free or cell-based) and isolating the HFE protein from the mediumor cells of the expression system. General expression vectors andsystems are well known in the art. In addition, the invention envisionsthe potential need to express a stable form of the HFE protein in orderto obtain high yields and obtain a form readily amenable to intravenousadministration. Stable high yield expression of proteins have beenachieved through systems utilizing lipid-linked forms of proteins asdescribed in Wettstein et al. J Exp Med 174:219–228 (1991) and Lin etal. Science 249:677–679 (1990).

HFE protein or portions thereof can be prepared synthetically.Alternatively, the HFE protein can be prepared from total proteinsamples by affinity chromatography. Sources would include tissuesexpressing normal HFE protein, in vitro systems (outlined above), orsynthetic materials. The affinity matrix would consist of antibodies(polyclonal or monoclonal) coupled to an inert matrix. In addition,various ligands which specifically interact with the HFE protein couldbe immobilized on an inert matrix, such as β-2-microglobulin or portionsthereof, β-2-microglobulin-like molecules, or other specific proteinssuch as calnexin and calnexin-like molecules or portions thereof.General methods for preparation and use of affinity matrices are wellknown in the art.

Protein replacement therapy requires that HFE polypeptides beadministered in an appropriate formulation. The HFE polypeptides can beformulated in conventional ways standard to the art for theadministration of protein substances. Delivery may require packaging inlipid-containing vesicles (such as Lipofectin™ or other cationic oranionic lipid or certain surfactant proteins) that facilitateincorporation into the cell membrane. The HFE protein formulations canbe delivered to affected tissues by different methods depending on theaffected tissue. For example, iron absorption is initiated in the GItract.

Therefore, delivery by catheter or other means to bypass the stomachwould be desirable. In other tissues, IV delivery will be the mostdirect approach.

The following examples are provided to illustrate certain aspects of thepresent invention and not intended as limiting the subject matterthereof:

EXPERIMENTAL EXAMPLES

A. Introduction

In this experimental example, we demonstrated that HFE forms a stablecomplex with the transferrin receptor (TfR), the molecule responsiblefor receptor-mediated endocytosis of iron-bound transferrin. Thisinteraction, assessed both in cultured cells by over-expression of HFEand also by addition of soluble HFE/β₂m heterodimers, causes a decreasein the apparent affinity of the TfR for transferrin. In contrast, thedisease-causing mutation (C282Y) fails to form this TfR complexpermitting high affinity binding of transferrin. These resultsestablished the first molecular link between HFE and iron absorption andindicate that an altered regulation of transferrin-dependent iron uptakeleads to HFE disease.

B. Methods

1. Cell Surface Protein Biotinylations. Cells (4×10⁶) were seeded into100 mm dishes and grown overnight to 80% confluency. The plates weremoved to 4° C. and gently washed four times with PBS. Suflo-NHS-LCBiotin (Pierce) was added in PBS to a final concentration of 500 μg/mland incubated on ice for 30 mins. The Biotin reagent was removed and theplates washed 4 times with PBS containing 50 mM glycine. Cells werelysed in 500 ml of 25mM Tris-HCL, pH 7.5 150 mM NaCl plus 0.5% NP-40.Protein concentrations were determined by BCA assay (Pierce) and one mgof protein was pre-cleared with Protein-G-Sepharose (Pharmacia) andimmunoprecipitated with either 10 mg of an anti-HFE rabbit polyclonalantibody (CT1) (Feder, J. N., et al. J. Biol. Chem. 272:14025–14028(1997)), 50 μg of FLAG (M2) monoclonal antibody (Kodak), 5 μg oftransferrin receptor monoclonal antibody (Caltag) or 10 μg of HLA-ABCantibody (Immunotech). Precipitated proteins were separated on 4–20%Tris-glycine polyacrylamide gels (Novex), electroblotted to PVDFmembranes (Novex) and biotinylated proteins were visualized with 2 μg/mlof streptavidin-HRP (Pierce) followed by ECL detection reagents(Amersham).

2. Immunoprecipitations and Western Blotting. Cells were lysed in thesame buffer as above and precipitations carried out with the sameantibodies and concentrations except that no pre-clearing step wascarried out. Precipitated proteins were separated and electroblotted toPVDF membranes as previously described (Feder, J. N., et al. J. Biol.Chem. 272:14025–14028 (1997).

3. Transferrin Binding Assays. Transferrin binding assays were carriedout as essentially as described (Ward, , J. H. et al., J. Biol. Chem.257:10317–10323 (1982)) with the following modifications. Cells wereseeded at a density of 6×10⁵ per well in 6-well dishes coated with 0.01%fibronectin (Sigma) and grown overnight. Cells were washed 1 time with 2ml of DME-H21 media containing 1% FBS and then incubated at either 37°C. or on ice with varying concentrations of transferrin which include[¹²⁵]-diferric transferrin (1 mCi/mg) (NEN) as a tracer ( 1/30th of thefinal concentration) in a final volume of 750 μl. To determine theamount of non-specific transferrin binding, cells were simultaneouslyincubated under the same conditions but in the presence of 100 times themolar concentration of cold holo-transferrin (Sigma). After 20 mins (37°C.) or 90 mins (4° C.), the media was removed and counted in a Beckman9600 scintillation counter. The-cells were incubated on ice and washed 2times with media containing 1% FBS, and then lysed with 1% SDS andcounted. Specific binding was calculated by substracting thenon-specific binding from the total binding. A second method was alsoused that utilized a constant amount of labeled transferrin (10 nM) andincreasing amount of unlabeled transferrin to increase the totaltransferrin concentration. Identical results to those produced by thefirst method were obtained.

4. Expression and Purification of Secreted HFE.

A secreted HFE/β₂m heterodimer was constructed as follows, wherein theamino acid sequence of the HFE is shown (SEQ ID NO:1):

RLLRSHSLHYLFMGASEQDLGLSLFEALGYVDDQLFVFYDHESRRVEPRTPWVSSRISSQMWLQLSQSLKGWDHMFTVDFWTIMENHNHSKESHTLQVILGCEMQEDNSTEGYWKYGYDGQDHLEFCPDTLDWRAAEPRAWPTKLEWERHKIRARQNRAYLERDCPAQLQQLLELGRGVLDQQVPPLVKVTHHVTSSVTTLRCRALNYYPQNITMKWLKDKQPMDAKEFEPKDVLPNGDGTYQGWITLAVPPGEEQRYTCQVEHPGLDQPLIVIWEA 5′ Xho I site, a stop codon after the codon corresponding to aminoacid 298 (residue 276 of the mature protein) and a 3′Not I site wereinserted in the HFE gene by site-directed mutagenesis. After verifyingthe sequence, the modified HFE gene was subcloned into the expressionvector PBJS-GS that carries the glutamine synthetase gene as aselectable marker and as a means of gene amplification in the presenceof the drug methionine sulfoximine (Bebbingtion, C. R. & Hentschel, C.G. G. in DNA Cloning: A Practical Approach. (ed. Glove, DM) 163–188(Oxford: Ill., 1987)). The HFE expression plasmid was cotransfected witha human β₂m expression vector (i.e., full length, wild type β₂m,Fahnestock, M. L., et al. Immunity 3:583–590 (1995)) into CHO cells.Cell lines secreting HFE/β₂m heterodimers were identified byimmunoprecipitation of supernatants of ³⁵S-methionine metabolicallylabeled cells using an antibody against human β₂m (BBM.1) (Parham, P. etal., J. Biol. Chem. 258:6179–6186 (1983)). A protein of molecular massof 43 kDa was co-immunoprecipitated with labeled β₂m from thesupernatants, and was verified to be the truncated HFE polypeptide chainby N-terminal sequencing of the purified protein (yielding the sequencesRLLRSHSLHYLF (SEQ ID NO:4) and IQRTPKIQVYSR (SEQ ID NO:5) correspondingto the correctly processed mature forms of HFE and human β₂m; data notshown). Soluble HFE/β₂m heterodimers were purified on a BBM.1immunoaffinity column, followed by separation of free β₂m from theheterodimers on a Superdex^((tm)) 75 HR 10/30 FPLC gel filtration columnor by using an immunoaffinity column constructed with an HFE monoclonalantibody raised against the purified heterodimer. 0.25 mg of purifiedsecreted HFE, FcRn and UL18 were treated with acetic acid and analysedfor the presence of bound peptides using established methods (Rotzschke,O., et al. Nature 348:252–257 (1990)) as previously described for UL18(Fahnestock, M. L., et al. Immunity 3:583–590 (1995)) and FcRn(Raghavah, M. et al., Biochemistry 32:8654–8660 (1993)). Acid eluateswere analyzed by Edman degradation using an Applied Biosystems Model477A protein sequencer for pool sequencing (Table 1). In order to detectN-terminally blocked peptides, the HFE and FcRn eluates were analyzed bymatrix-assisted, laser desorption, time-of-flight mass spectrometryusing a PersSeptive Biosystems ELITE mass spectrometer.

Site-directed mutation was used to introduce a missense mutation to theHFE gene to produce HFE protein in which His-63 is replaced by anaspartic acid residue. The H63D mutant HFE gene was expressed in CHOcells and secreted H63D-HFE/β₂m heterodimers were purified. The aminoacid sequence of the H63D-HFE protein is shown (SEQ ID NO:2):

RLLRSHSLHYLFMGASEQDLGLSLFEALGYVDDqLFVFYDDESRRVEPRTPWVSSRISSQMWLQLSQSLKGWDHMFTVDFWTIMENHNHSKESHTLQVILGCEMQEDNSTEGYWKYGYDGQDHLEFCPDTLDWRAAEPRAWPTKLEWERHKIRARQNRAYLERDCPAQLQQLLELGRGVLDQQVPPLVKVTHHVTSSVTTLRCRALNYYPQNITMKWLKDKQPMDAKEFEPKDVLPNGDGTYQGWITLAVPPGEEQRYTCQVEHPGLDQPLIVIWE

The role of two His residues, i.e., His-111 and His-145, in HFE-TfRbinding was also analyzed by replacing both residues with an Ala residuethrough site-directed mutagenesis, yielding a soluble H111A/H145Amutant. The amino acid sequence of the H111A/H145A-HFE protein is shown(SEQ ID NO:3):

RLLRSHSLHYLFMGASEQDLGLSLFEALGYVDDQLFVFYDHESRRVEPRTPWVSSRISSQMWLQLSQSLKGWDHMFTVDFWTIMENHNASKESHTLQVILGCEMQEDNSTEGYWKYGYDGQDALEFCPDTLDWRAAEPRAWPTKLEWERHKIRARQNRAYLERDCPAQLQQLLELGRGVLDQQVPPLVKVTHHVTSSVTTLRCRALNYYPQNITMKWLKDKQPMDAKEFEPKDVLPNGDGTYQGWITLAVPPGEEQRYTCQVEHPGLDQPLIVIWE

TABLE 1 pmole of amino acids recovered from acid elutions. Cycle numberHFE FcRn UL18 1 2.1 5.9 86.0 2 0.5 4.7 75.1 (Leu, Met = 71) 3 0.4 0.736.9 (Pro = 19) 4 0.8 7.6 19.8 5 0.0 0.0 11.3 6 3.5 0.0 4.0 7 1.0 0.23.7 8 0.0 0.6 6.5 9 1.9 9.5 4.3 10 0.0 0.3 1.3The total yield of amino acids from each sequencing cycle is presentedfor acid eluates derived from equivalent amount of soluble HFE, FcRN andUL18 heterodimers. Only those amino acid residues that showed anincrease in the absolute amount recovered compared to the previous cyclewere considered significant. Results for the FcRn and UL18 eluates aresimilar to those previously reported (Fahnestock, M. L., et al. Immunity3:583–590 (1995); Raghavah, M. et al., Biochemistry 32:8654–8660 (1993))in which UL18, but not FcRn, was shown to bind endogenous peptides.C. Results and Discussion

To investigate the role of HFE in the regulation of iron metabolism, weutilized cell-surface labeling to detect potential HFE interactiveproteins. Human embryonic kidney cells (293 cells), engineered toover-express either wild-type or mutant forms of HFE, were treated withbiotin-conjugated N-hydroxysuccinimide (NHS-biotin) to label proteinsexpressed on the cell-surface. Subsequently, total cell lysates wereimmunoprecipitated with previously characterized antibodies directedtoward the C-terminal peptide sequence of HFE or monoclonal antibodiesagainst the FLAG epitope tag which had been engineered into the HFEprotein (Feder, J. N., et al. J. Biol. Chem. 272:14025–14028 (1997)).Biotinylated proteins were detected with streptavidin-conjugatedhorseradish peroxidase (HRP). Lysates from parental 293 cells displayedlittle surface-labeling in accordance with previous results,demonstrating undetectable levels of HFE protein in these cells (FIGS.1A and B) (Feder, J. N., et al. J. Biol. Chem. 272:14025–14028 (1997)).In contrast, prominent bands of 12, 49, 100 and 200 kDa were observed inlysates from cells overexpressing the wild-type HFE; these bands wereabsent from immunoprecipitates from cells overexpressing the C282Ymutant form of HFE (FIGS. 1A and B). In previous studies demonstratedthat the plasma membrane-bound form of HFE was 49 kDa in molecular massand associated with β₂m, a 12 kDa protein (Feder, J. N., et al. J. Biol.Chem. 272:14025–14028 (1997)). The presence of 49 and 12 kDa labeledbands in HFE-specific immune-complexes from wild-type HFE expressingcells and their absence in parental and C282Y mutant expressing cells isconsistent with their identity as HFE and β₂m. The failure of the 100and 200 kDa proteins to be co-immunoprecipitated from the C282Y mutantexpressing cells indicates a specific interaction of these proteins withthe cell-surface form of HFE.

To determine the specificity of these protein interactions with HFE, weperformed immunoprecipitations with antibodies that recognize therelated HLA-A, B and C proteins. These antibodies detected proteins atapproximately 45 kDa and 12 kDa, the predicted molecular masses of HLAheavy chain and β₂m, but failed to co-immunoprecipitate the 100 and 200kDa bands (FIG. 1D).

To identify the 100 and 200 kDa proteins which co-immunoprecipitatedwith HFE, we investigated proteins known to participate in ironhomeostasis. Interestingly, the major carrier of transferrin-bound iron,the transferrin receptor (TfR) is known to display a characteristicpattern of monomers and dimers migrating at approximately 100 and 200kDa in denaturing gel electrophoresis (Seligman, P. A. et al. J. Biol.Chem. 254:9943–9946 (1979); Wada, H. G. et al., J. Biol. Chem.254:12629–12635 (1979); Omary, M. B. et al., J. Biol. Chem.256:12888–12892 (1981)). To determine whether HFE could associate withthe TfR, we utilized TfR antibodies to immunoprecipitate surface-labeledproteins from the three cell lines. Two prominent proteins of molecularmass corresponding to the monomeric and dimeric forms of the TfR wereseen in the parental 293 as well as the wild-type HFE and the C282Ymutant HFE expressing cell lines (FIG. 1C). Significantly, two proteinswith masses corresponding to those of HFE and β₂m (49 kDa and 12 kDa,respectively) were observed only in lysates from the cells whichoverexpress wild-type HFE but not in lysates from the parental 293 orC282Y mutant protein expressing cells.

The HFE/TfR association results were corroborated by performingco-immunoprecipitation experiments on unlabeled total cell lysates.Immunoprecipitation with HFE antibodies followed by blotting and probingwith antibodies to TfR demonstrated that the TfR was complexed only withthe wild-type form of HFE but not with the C282Y mutant (FIG. 2A).Stripping this blot and reprobing with the FLAG epitope antibodies todetect HFE, demonstrated that equivalent amounts of HFE are beingexpressed and immunoprecipitated from each of the cell lines but, asexpected, are absent in the parental 293 cells (FIG. 2B). Performing theinverse experiment, wherein cell lysates were first immunoprecipitatedwith TfR antibodies followed by blotting with HFE antibodies, revealedthat HFE co-immunoprecipitated with the TfR from the wild-typeexpressing cells but not the C282Y or parental 293 cell lines (FIG. 2C).The absence of HFE in the parental 293 and C282Y mutant cell lines wasnot due to failure to precipitate TfR; reprobing the blot with TfRantibodies demonstrated that similar amounts of TfR protein wereprecipitated from each of the cell lines (FIG. 2D). To further controlfor the specificity of the HFE antibodies, we first immunoprecipitatedcell lysates with FLAG epitope antibodies to specifically precipitatethe HFE/FLAG fusion proteins followed by blotting with TfR antibodies.As in FIG. 2A, the TfR was co-immunoprecipitated in the wild-type HFEexpressing cells but not from the C282Y mutant expressing cells (FIG.2E). Experiments performed on an independent series of cell linesengineered to express wild-type and mutant HFE which lacked the FLAGepitope tag yielded identical results to those shown in FIG. 2A–2E whenimmunoprecipitations were carried out with HFE and TfR antibodies.

In immunoprecipitation experiments on unlabeled cell lysates we includedas a further control another mutant of HFE wherein histidine 63 wasreplaced by aspartate (H63D). As with wild-type HFE, the H63D protein isalso expressed on the cell surface (Feder, J. N., et al. J. Biol. Chem.272:14025–14028 (1997)), however, functional effect of this mutation hasyet been identified. The association of HFE with the TfR as assessed byco-immunoprecipitation appeared unaffected by the H63D mutation (FIG.2A–E).

To assess the biological effect of the HFE/TfR interaction, wecharacterized the transferrin-binding properties of the TfR in thepresence or absence of HFE. For these studies we examined[¹²⁵I]-diferric transferrin binding to intact 293 cells engineered toover-express both β₂m and the wild-type or the C282Y mutant forms ofHFE. The latter served as a baseline comparison since our earlierstudies demonstrated that the C282Y mutant was not expressed on the cellsurface (Feder, J. N., et al. J. Biol. Chem. 272:14025–14028 (1997)),and failed to interact with the TfR (FIGS. 1 and 2). In addition, theC282Y cell lines, like the wild-type cell lines, were selected for inG418. The initial binding experiments were performed at 37° C., whichallowed the total [¹²⁵¹]-diferric transferrin bound to be representativeof both surface-bound and internalized ligand (Karin, M. et al., J.Biol. Chem. 256:3245–3252 (1981); Octave, J. N. et al., Eur. J. Biochem.123:235–240 (1982). The binding of [¹²⁵I]-diferric transferrin saturatedat 150–300 nM on both C282Y mutant and wild-type HFE expressing cells(FIGS. 3A and B insets, which present data from two separate cell clonesfor each the wild-type and mutant HFE). When subjected to Scatchardanalysis, the C282Y HFE mutant expressing clones bound transferrin withan apparent K_(D) of approximately 12 and 14 nM and expressedapproximately 2.3×10⁵ and 3.3×10⁵ transferrin binding sites per cell,respectively (FIG. 3A). These data were similar to values reportedpreviously for other cultured cell lines (Mulford, C. A. et al. J. Biol.Chem. 263:5455–5461 (1988); Ward, J. H. et al. J. Biol. Chem.257:10317–10323 (1982)), suggesting that binding and trafficking of theTfR to the cell surface in the mutant HFE-expressing cells was normal.By contrast, the affinity of the TfR for transferrin, in the wild-typeHFE expressing clones, was reduced 4 and 15-fold to apparent K_(D)values of 40 and 180 nM respectively, while expressing approximately3.0×10⁵ apparent transferrin binding sites per cell (FIG. 3B). Takentogether, these results suggest that the presence or absence of the HFEprotein on the cell surface affects the apparent K_(D) of the TfR fortransferrin.

As an alternative method to assess the effect of HFE on transferrinbinding to the TfR, we added a soluble form of HFE/β₂m heterodimer tothe culture medium of parental 293 cells. At 37° C. the binding oftransferrin to parental 293 cells occurred with an apparent K_(D Of) 19nM. In contrast, the apparent K_(D) for the binding of transferrin tothe TfR in the presence of 2 μM soluble HFE/β₂m heterodimer was reduced5-fold to 100 nM. The apparent number of transferrin binding sites wasalso reduced from 1.25×10⁵ to 5.0¹⁰ ⁴ per cell, a reduction of 60% (FIG.3C), suggesting that the rate of receptor internalization without boundtransferrin may be increased in the presence of HFE. To determinewhether the regulation of the apparent K_(D) of the TfR was specific forthe HFE protein, we added an equivalent amount of a soluble version of aclassical MHC class I protein, purified H-2K^(d) complexed with humanβ₂m (Fahnestock, M. L. et al., Science 258:1658–1662 (1992)) to theassay. Addition of this protein had no effect on transferrin binding tothe TfR (FIG. 3C) demonstrating that the effect is not solely due to thepresence of human β₂m alone. These experiments independently demonstratethat HFE can effectively lower the affinity of TfR for transferrin andthat this effect appears to be a specific property of HFE.

The availability of soluble HFE/β₂m heterodimers permitted aninvestigation for other possible ligands for HFE, in particular smallpeptides which are known to bind class I molecules. The soluble HFE/β₂mheterodimers were expressed in CHO cells and analyzed for the presenceof endogenous peptides by comparing amino acids recovered in acideluates from HFE with those from other MHC-like proteins which either door do not bind peptides (UL18 protein (Fahnestock, M. L., et al.Immunity 3:583–590 (1995)) and rat FcRn protein (Raghavah, M. et al.,Biochemistry 32:8654–8660 (1993)), respectively). There was no evidencethat peptides were bound to the HFE protein (See Table 1 and Methods).N-terminal protein sequencing demonstrated that no associating proteinswere present with the exception of β₂m (see Methods). Hence, our studyhas identified only one significant associated polypeptide, thetransferrin receptor.

The primary defects in hereditary hemochromatosis appear to be increasediron absorption in the small intestine as well as increased irondeposition in major organs. We have demonstrated that HFE forms a stablecomplex with the transferrin receptor with the consequence of repressingtransferrin uptake. The C282Y mutation is capable of eliminating thisinteraction. Without being limited to any one theory, these data suggesta mechanism for iron deposition in HFE where a loss of HFE transferrinuptake-repressor function would result in increased cellular uptake ofiron. However, the role of this mechanism in intestinal iron absorptionis less clear. Recent immunohistochemical studies have localized HFE tothe intracellular portion of the cells in the deep crypts of theduodenum (Parkkila, S., et al. Proc. Natl. Acad. Sci. USA 94:2534–2539(1997)), the same region where previous studies have localized the TfR(Banerjee, D. B. et al., Gastroenterology 91:861–869 (1986); Anderson,G. J. et al., Gastroenterology 98:576–585 (1990)). The role of the TfRin the cells of the deep crypts has long been thought to be limited toservicing the proliferative needs of these cells. In light of theassociation of HFE and the TfR, one must now reconsider the role oftransferrin and its receptor in intestinal iron absorption. Regardlessof the actual mechanism, the observations described here provide thefirst molecular link between HFE and iron metabolism. Furthermore, theseresults demonstrate that by administering HFE protein in situ the amountof transferrin taken up by cells can be attenuated, thereby offering atherapeutic alternative to iron-chelators utilized in iron-overloadsyndromes of-either primary or secondary nature.

In addition, an analysis of the naturally occurring H63D HFE mutation(H41D of the mature protein) was carried out to determine its effect onthe affinity of the transferrin receptor for transferrin. The purifiedH63D-HFE/β₂m heterodimers were then added to HeLa cells grown in cultureand the binding and uptake of ¹²⁵I-transferrin measured (“HeLa cellbased assay”). It was observed that H63D-HFE/β₂m heterodimers were30–40% less efficient in their ability to decrease the transferrinreceptor's (“TfR”) affinity for transferrin when compared to normal,i.e., wild-type, HFE. At the concentration of 250 nM H63D HFE/β₂mheterodimers, the TfR had a K_(D) for transferrin of 28 nM. At the sameconcentration of normal HFE/β₂m heterodimers, the TfR had a K_(D) fortransferrin of 40 nM. In the absence of any HFE/β₂m heterodimers, theTfR had a K_(D) for transferrin of 7 nM. These data are in agreementwith results obtained from experiments in which the H63D mutant proteinwas overexpressed in 293 cells.

The K_(D) of the H63D-HFE/β₂m heterodimers was determined asapproximately 105 nM, which is a 50% increase over that observed withthe normal HFE/β₂m heterodimers in the same experiment. These datasuggest that the H63D mutation decreases the ability of HFE to alter TfRaffinity for transferrin. Therefore, in the presence of the H63Dmutation, HFE binds the TfR without decreasing cellular iron uptake tothe same degree as the wild-type HFE protein. Therefore, this mutantprotein is useful in increasing intracellular concentrations of iron.This soluble protein is expected to bind the TfR on the cell surfaceand, at an appropriate concentration, out-compete the normal (wild-type)HFE protein for the formation of the HFE/TfR complex. The result wouldbe that the TfR would increase uptake of iron-associated transferrininto the cell.

A soluble form of the H111A/H145A mutant was purified. TheH111A/H145A-HFE/β₂m heterodimer was tested, using the HeLa cell basedassay, for its ability to alter the affinity of TfR for transferrin. Atneutral pH and in the presence of 250 nM H111A/H145A-HFE/β₂mheterodimers, the TfR bound transferrin with a K_(D) of 12 nM, whereasin the presence of 250 nM wild-type HFE/β₂m heterodimers the TfR boundtransferrin with a K_(D) of 54 nM. In the absence of any form of HFE,TfR bound transferrin with a K_(D) of 5 nM. These data also indicatethat the H111A/H145A mutant form of HFE, like the H63D mutation, supra,can be useful to increase intracellular iron concentrations bycompetitively inhibiting the wild-type HFE protein for binding to TfR.Thus, the H111A/H145A mutant of HFE protein may be useful to treat irondeficiency diseases and conditions, like, for example, anemia.

All references (including books, articles, papers, patents, and patentapplications) cited herein are hereby expressly incorporated byreference in their entirety for all purposes.

While the invention has been described in connection with specificembodiments thereof, it will be understood that it is capable of furthermodification, and this application is intended to cover any variations,uses, or adaptations of the invention following, in general, theprinciples of the invention and including such departures from thepresent disclosure as come within known or customary practice in the artto which the invention pertains and as may be applied to the essentialfeatures hereinbefore set forth, and as fall within the scope of theinvention and the limits of the appended claims.

1. A composition comprising an isolated hereditary hemochromatosis (HFE)polypeptide consisting of the amino acid sequence of SEQ ID NO:1 and afull length, wild-type human β₂ microglobulin (β₂m).
 2. A compositioncomprising an isolated HFE polypeptide consisting of the amino acidsequence of SEQ ID NO:2 and a full length, wild-type human β₂m.
 3. Acomposition comprising an HFE polypeptide having the amino acid sequenceof SEQ ID NO:3 and a full length, wild-type human β₂m.
 4. A compositioncomprising an isolated HFE polypeptide comprising the amino acidsequence of SEQ ID NO:2 and a full length, wild-type human β₂m, whereinthe HFE polypeptide and the human β₂m are in a secreted soluble complexsuitable for administration to a subject.
 5. A composition comprising anisolated HFE polypeptide comprising the amino acid sequence of SEQ IDNO:1 and a full length, wild-type human β₂m, wherein the HFE polypeptideand the human β₂m are in a secreted soluble complex suitable foradministration to a subject.